Faster recovery of soil biodiversity in native species mixture than in Eucalyptus monoculture after 60 years afforestation in tropical degraded coastal terraces.

Afforestation is an effective method to restore degraded land. Afforestation methods vary in their effects on ecosystem multifunctionality, but their effects on soil biodiversity have been largely overlooked. Here, we mapped the biodiversity and functioning of multiple soil organism groups resulting from diverse afforestation methods in tropical coastal terraces. Sixty years after afforestation from bare land (BL), plant species richness and the abundance of plant litter (398 ± 85 g m-2 ) and plant biomass (179 ± 3.7 t ha-1 ) in native tree species mixtures (MF) were restored to the level of native forests (NF; 287 ± 21 g m-2 and 243.0 ± 33 t ha-1 , respectively), while Eucalyptus monoculture (EP) only successfully restored the litter mass (388 ± 43 g m-2 ) to the level of NF. Soil fertility in EP and MF was increased but remained lower than in NF. For example, soil nitrogen and phosphorus concentrations in MF (1.2 ± 0.2 g kg-1 and 408 ± 49 mg kg-1 , respectively; p < 0.05) were lower than in NF (1.8 ± 0.2 g kg-1 and 523 ± 24 mg kg-1 , respectively; p < 0.05). Soil biodiversity, abundance (except for nematodes), and community composition in MF were similar or greater than those in NF. In contrast, restoration with EP only enhanced the diversity of microbes and mites to the level of NF, but not for other soil biota. Together, afforestation with native species mixtures can end up restoring vegetation and most aspects of the taxonomic and functional biodiversity in soil whereas monoculture using fast-growing non-native species cannot. Native species mixtures show a greater potential to reach completely similar levels of soil biodiversity in local natural forests if they are received some more decades of afforestation. Multifunctionality of soil biotic community should be considered to accelerate such processes in future restoration practices.

Phosphorus addition decreases microbial residual contribution to soil organic carbon pool in a tropical coastal forest.

The soil nitrogen (N) and phosphorus (P) availability often constrains soil carbon (C) pool, and elevated N deposition could further intensify soil P limitation, which may affect soil C cycling in these N-rich and P-poor ecosystems. Soil microbial residues may not only affect soil organic carbon (SOC) pool but also impact SOC stability through soil aggregation. However, how soil nutrient availability and aggregate fractions affect microbial residues and the microbial residue contribution to SOC is still not well understood. We took advantage of a 10-year field fertilization experiment to investigate the effects of nutrient additions, soil aggregate fractions, and their interactions on the concentrations of soil microbial residues and their contribution to SOC accumulation in a tropical coastal forest. We found that continuous P addition greatly decreased the concentrations of microbial residues and their contribution to SOC, whereas N addition had no significant effect. The P-stimulated decreases in microbial residues and their contribution to SOC were presumably due to enhanced recycling of microbial residues via increased activity of residue-decomposing enzymes. The interactive effects between soil aggregate fraction and nutrient addition were not significant, suggesting a weak role of physical protection by soil aggregates in mediating microbial responses to altered soil nutrient availability. Our data suggest that the mechanisms driving microbial residue responses to increased N and P availability might be different, and the P-induced decrease in the contribution of microbial residues might be unfavorable for the stability of SOC in N-rich and P-poor tropical forests. Such information is critical for understanding the role of tropical forests in the global carbon cycle.

Premature closure or restriction of the foramen ovale: prenatal diagnosis by directional enhanced flow imaging.

Premature closure or restriction of the foramen ovale may occur at any time during pregnancy and may be due to various causes. We describe 2 patients with premature closure or restriction of the foramen ovale during the third trimester. In both patients the foramen ovale was detected by directional enhanced flow imaging technology (DeFLOW; Hitachi-Aloka Medical, Ltd, Tokyo, Japan), a novel method of imaging blood flow dynamics. Our findings indicate that D-eFLOW can display blood flow information with higher sensitivity and resolution than conventional methods, helping obstetricians and pregnant women make timely decisions about delivery.

Analysis of coronary flow haemodynamics in homozygous familial hypercholesterolaemic adolescents with aortic supravalvular stenosis.

OBJECTIVE: To study coronary artery haemodynamics in adolescents with homozygous familial hypercholesterolaemia and aortic supravalvular stenosis. METHODS: Patients diagnosed with familial hypercholesterolaemia who were younger than 16 years and who had undergone transthoracic echocardiography from 2007 to 2010 were included in this study. We included patients with homozygous familial hypercholesterolaemia and aortic supravalvular stenosis and those with heterozygous familial hypercholesterolaemia. All patients underwent stress echocardiography, and left anterior descending coronary artery flow was successfully detected. Coronary flow velocity reserve was calculated as the ratio of hyperaemic mean diastolic flow velocity after injection of adenosine to basal mean diastolic flow velocity. Changes in coronary haemodynamics and the relationship between lipid concentrations were determined. RESULTS: A total of 11 patients with homozygous familial hypercholesterolaemia were enrolled in this study. Lipid concentrations were measured, and the mean coronary flow velocity reserve was 1.97 plus or minus 0.51. Seven children were included in the group of patients with heterozygous familial hypercholesterolaemia. In these children, the mean coronary flow velocity reserve was 3.08 plus or minus 0.84. CONCLUSION: The coronary flow velocity reserve of homozygous familial hypercholesterolaemic patients is lower than that of heterozygous familial hypercholesterolaemic patients, and it is associated with a high concentration of low-density lipoprotein cholesterol. Aortic stenosis and plaques compromised the ostia of the coronary artery and caused increased basal mean diastolic coronary velocity with blunted increase in peak velocity, which decreased the coronary flow velocity reserve.

Regional atrial myocardial velocity in normal fetuses: evaluation by quantitative tissue velocity imaging.

OBJECTIVES: Quantitative tissue velocity imaging (QTVI) is a new noninvasive method that derives measurements of velocities directly from the myocardium. Data on atrial myocardial tissue velocities in normal fetuses have not been established. The objective of this study was to evaluate atrial myocardial velocity and the myocardial velocity gradient of normal fetuses by using QTVI. METHODS: We measured motion velocities of the left and right atrial wall along the long axis in 50 normal fetuses aged 21-32 weeks gestation (mean, 25.3 ± 2.8 weeks). In all fetuses, peak myocardial velocity during early diastole (EW), atrial contraction (AW), and ventricular systole (SW) waves was recorded in the basal and mid-atrial segments. Correlation analysis was conducted between segmental velocities of the left atrium (LA) and right atrium (RA) and gestational age. RESULTS: The mean values for EW, AW, and SW of the long axis in the same right basal segment of the RA were greater than those of the LA (P < 0.01). There was a degressive gradient with velocity from the basal to superior in the atrial wall. There was a linear relationship with gestation for all basal myocardial velocities of the left and right atrial free wall (P < 0.05). However, the myocardial velocity variables of the midatrial wall showed no age-dependence. CONCLUSION: We demonstrated that QTVI is reproducible and provides readily obtained parameters that provide unique data regarding segmental atrial myocardial velocity in normal fetuses.

Left anterior descending artery occlusion secondary to blunt chest trauma diagnosed by comprehensive echocardiography and coronary angiography.

Blunt chest trauma can cause serious complications, but coronary artery occlusion is rare. In a 19-year-old man, 40 days after a motorcycle accident, comprehensive echocardiography detected left anterior descending artery occlusion and left ventricular dysfunction, which was confirmed by coronary angiography and ventriculography. Echocardiography was also able to confirm restored left anterior descending artery flow and improved left ventricular function after coronary artery bypass grafting.

The genome of the Paleogene relic tree Bretschneidera sinensis: insights into trade-offs in gene family evolution, demographic history, and adaptive SNPs.

Among relic species, genomic information may provide the key to inferring their long-term survival. Therefore, in this study, we investigated the genome of the Paleogene relic tree species, Bretschneidera sinensis, which is a rare endemic species within southeastern Asia. Specifically, we assembled a high-quality genome for B. sinensis using PacBio high-fidelity and high-throughput chromosome conformation capture reads and annotated it with long and short RNA sequencing reads. Using the genome, we then detected a trade-off between active and passive disease defences among the gene families. Gene families involved in salicylic acid and MAPK signalling pathways expanded as active defence mechanisms against disease, but families involved in terpene synthase activity as passive defences contracted. When inferring the long evolutionary history of B. sinensis, we detected population declines corresponding to historical climate change around the Eocene-Oligocene transition and to climatic fluctuations in the Quaternary. Additionally, based on this genome, we identified 388 single nucleotide polymorphisms (SNPs) that were likely under selection, and showed diverse functions in growth and stress responses. Among them, we further found 41 climate-associated SNPs. The genome of B. sinensis and the SNP dataset will be important resources for understanding extinction/diversification processes using comparative genomics in different lineages.

Deciphering the mysteries of crisscross heart by transthoracic echocardiography.

BACKGROUND: Accurate diagnosis of crisscross heart and its associated anomalies is important but problematic for cardiologists. This study aimed at identifying unique transthoracic echocardiographic features and common associated lesions of this complex condition. METHOD: Clinical and echocardiographic features of 10 patients with crisscross anatomy were studied. Echocardiographic findings were verified by cardiac magnetic resonance imaging or surgical inspection. RESULTS: Crisscross anatomy (10 patients, age at diagnosis ranged from 1 month to 25 years, five female) was identified in 0.076% of patients with congenital heart diseases from 1985 to 2006. All patients had cyanosis and 80% of them were underweight. Superior-inferior ventricles (SIV) and crossed ventricular inflow streams were seen in 90% and 100% of patients, respectively. All patients had abnormal ventriculo-arterial (VA) connections: five with transposition of great artery (L-type: n = 2; D-type: n = 3) and five with double outlet right ventricle. Commonly associated anomalies included ventricular septal defects (100%), right ventricular outflow tract obstruction (60%), atrioventricular valves straddling or overriding (50%), atrial septal defect (40%), and right ventricular hypoplasia (30%). Seven patients received cardiac surgery for the relief of cyanosis. CONCLUSIONS: SIV and crossed inflow streams are important diagnostic features for crisscross heart by transthoracic echocardiogram. The hemodynamic consequences of abnormal VA connections and associated defects impact surgical management.

Global blue carbon accumulation in tidal wetlands increases with climate change.

Coastal tidal wetlands produce and accumulate significant amounts of organic carbon (C) that help to mitigate climate change. However, previous data limitations have prevented a robust evaluation of the global rates and mechanisms driving C accumulation. Here, we go beyond recent soil C stock estimates to reveal global tidal wetland C accumulation and predict changes under relative sea level rise, temperature and precipitation. We use data from literature study sites and our new observations spanning wide latitudinal gradients and 20 countries. Globally, tidal wetlands accumulate 53.65 (95%CI: 48.52-59.01) Tg C yr-1, which is ∼30% of the organic C buried on the ocean floor. Modeling based on current climatic drivers and under projected emissions scenarios revealed a net increase in the global C accumulation by 2100. This rapid increase is driven by sea level rise in tidal marshes, and higher temperature and precipitation in mangroves. Countries with large areas of coastal wetlands, like Indonesia and Mexico, are more susceptible to tidal wetland C losses under climate change, while regions such as Australia, Brazil, the USA and China will experience a significant C accumulation increase under all projected scenarios.

The complete chloroplast genome of Ormosia purpureiflora (Fabaceae).

Ormosia purpureiflora is endemic to China. It is named after its purple flowers. It is a small tree only up to 3 m. It has leathery leaves, racemose inflorescences. The seeds are elliptic and red in coat. It is only confined to Luofushan Provincial Nature Reserve in Huizhou of Guangdong Province. Herein, we first reported on its complete chloroplast genome sequence as genomic resource for conservation purposes. The chloroplast genome of O. purpureiflora was 173,364 bp in length, with a large single-copy region of 73,465 bp, a small single-copy region of 18,751 bp, and a pair of inverted repeat regions that were 40,574 bp each. A total of 90 protein-coding genes, 38 transfer RNA genes, and eight ribosomal RNA genes were predicted, while 106 simple sequence repeats were recorded throughout the genome. Phylogenetic analysis revealed that O. purpureiflora was sister to O. emarginata.

PDA with Eisenmenger complicated by pulmonary artery dissection.

A 49-year-old lady, known to have Eisenmenger PDA, careful transthoracic echocardiogram, showed clear evidence for pulmonary trunk dissection with a flap across the pulmonary trunk and this finding was confirmed by a CT scan.

Noninvasive evaluation of coronary flow velocity reserve in homozygous familial hypercholesterolemia by transthoracic Doppler echocardiography.

OBJECTIVE: To evaluate the value of transthoracic Doppler echocardiography (TTDE) of the left anterior descending coronary for the detection of early abnormalities of coronary arteries in asymptomatic patients with homozygous familial hypercholesterolemia (HoFH). METHODS: Seventeen asymptomatic patients with HoFH and 10 controls had plasma total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides measured and underwent TTDE of their left coronary descending artery to determine peak and mean flow velocities under basal conditions and under hyperemia induced by adenosine infusion. Coronary flow velocity reserve (CFVR) was calculated from the mean flow velocities. The presence of aortic supravalvular stenosis was also determined from supravalvular flow velocity and aortic valve thickening values. RESULTS: HoFH patients had similar basal but significantly lower hyperemic flow velocities and CFVR than control patients. Eight of the 17 HoFH patients had supravalvular aortic stenosis, and these patients had significantly higher LDL cholesterol and lower CFVR than those without this stenosis. Treatment with lipid-lowering drugs lowered lipid levels and increased CFVR values, but neither of these parameters reached normal values. CONCLUSIONS: TTDE is a suitable noninvasive technique to detect early abnormalities of coronary arteries and to monitor the clinical efficacy of lipid-lowering treatment in asymptomatic HoFH patients.

Tetra-imidazolium piperazinediium bis-(benzene-1,3,5-tricarboxyl-ate) dihydrate.

During the crystallization of the title compound, 4C(3)H(5)N(2) (+)·C(4)H(12)N(2) (+)·2C(9)H(3)O(6) (3-)·2H(2)O, the acidic protons were transferred to the imidazole and piperazine N atoms, forming the final 4:1:2:2 hydrated mixed salt. The mean planes of the three carboxyl-ate groups in the anion are twisted with respect to the the central benzene ring, making dihedral angles of 13.5 (1), 14.5 (1) and 16.9 (1)°. In the crystal, the component ions are linked into a three-dimensional network by a combination of inter-molecular N-H⋯O, O-H⋯O and weak C-H⋯O hydrogen bonds. Further stabilization is provided by π-π stacking inter-actions with centroid-centroid distances of 3.393 (2) Šand weak C=O⋯π inter-actions [O-centroid = 3.363 (2) Å].

Leaf nonstructural carbohydrate concentrations of understory woody species regulated by soil phosphorus availability in a tropical forest.

Leaf soluble sugars and starch are important components of nonstructural carbohydrates (NSCs), which are crucial for plant growth, development, and reproduction. Although there is a large body of research focusing on the regulation of plant NSC (soluble sugars and starch) concentrations, the response of foliar NSC concentrations to continuous nitrogen (N) and phosphorus (P) addition is still unclear, especially in tropical forests. Here, we used a long-term manipulative field experiment to investigate the response of leaf NSC concentrations to continuous N and P addition (3-, 5-, and 8-year fertilization) in a tropical forest in southern China. We found significant species-specific variation in leaf NSC concentrations in this tropical forest. Phosphorus addition dramatically decreased both leaf soluble sugar and starch concentrations, while N addition had no significant effects on leaf soluble sugar and starch concentrations. These results suggest that, in plants growing in P-limiting tropical soil, leaf NSC concentrations are regulated by soil P availability rather than N availability. Moreover, the negative relationships between NSC concentrations and leaf mass per area (LMA) revealed that NSCs could supply excess carbon (C) for leaf expansion under P addition. This was further supported by the increased structural P fraction after P fertilization in our previous study at the same site. We conclude that soil P availability strongly regulates leaf starch and soluble sugar concentrations in the tropical tree species included in this study. The response of leaf NSC concentrations to long-term N and P addition can reflect the close relationships between plant C dynamics and soil nutrient availability in tropical forests. Maintaining relatively higher leaf NSC concentrations in tropical plants can be a potential mechanism for adapting to P-deficient conditions.

[Assessment of cardiac twist in dilated cardiomyopathy using echocardiography velocity vector imaging].

OBJECTIVE: To assess cardiac twist in dilated cardiomyopathy (DCM) patients using echocardiography velocity vector imaging (VVI) and to explore the clinical application value of VVI in evaluating cardiac twist. METHODS: Thirty-three normal subjects and 30 DCM patients were enrolled. Echocardiographs of parasternal left ventricle basal, papillary muscle level and apical short axis plane, apical four-, two-chamber plane were obtained respectively. Systolic maximal rotation degree, peak rotation velocity, circumferential strain (CS), time to peak rotation velocity (TPRV), peak un-rotation velocity of end diastole and end isovolumic relaxation period in subendocardium were measured by VVI software. RESULTS: (1) In the normal group, left ventricle performed systolic wring motion with counterclockwise rotation at the apex and clockwise rotation at the base as seen from the apex, while with transient counterclockwise rotation at the base and clockwise rotation at the apex in isovolumic relaxation period. The papillary level rotation form was not constant For the dominant rotation action of the apex, the whole cardiac twist form was counterclockwise. (2) Compared with the control group, 4 DCM patients cardiac twist pattern changed: two showed both counterclockwise rotation of the base and the apex, one represented both clockwise rotation of the base and the apex, another performed the base rotated counterclockwise and the apex rotated clockwise. (3) All rotation and twist parameters of other 26 DCM patients decreased, especially at the apical level: LVtw:7.34 degrees +/- 3.65 degrees vs. 17.01 degrees +/- 4.81 degrees, LVtor: (0.09 +/- 0.04) degrees/mm vs. (0.23 +/- 0.06) degrees/mm, torsion rate: (60.23 +/- 23.67) degrees/s vs. (148.24 +/- 56.23) degrees/s, untwisting rate (0.37 +/- 0.19) degrees/m vs. (0.59 +/- 0.33%)/m, basal CS: (-8.09 +/- 2.73)% vs. (-19.49 +/- 5.51)% (P = 0.013), apical CS: (-8.94 +/- 5.90)% vs. (-27.49 +/- 9.53)% (P = 0.000), basal rotation angle: (-3.60 +/- 2.38) vs. (-6.28 +/- 3.05) (P = 0.014), apical rotation angle: (5.80 +/- 3.55) degrees vs. (11.02 +/- 3.33) degrees (P = 0.001). (4) The apical TPRV in DCM group were longer than the control group represented rotational dyssynchrony in DCM patients (400.26 ms +/- 70.15 ms vs 328.13 ms +/- 66.95 ms, P = 0.008). LVtw correlated positively well with EF (r = 0.489, P < 0.05). CONCLUSION: (1) Cardiac twist function was diffusely impaired in DCM patients and it contributed to the global cardiac dysfunction. (2) Cardiac twist pattern changed in some of DCM patients. (3) VVI can objectively reflect cardiac twist function in DCM patients.

[Evaluation of right ventricular function of patients with intraoperative device closure of atrial septal defect by ultrasonic Doppler tissue imaging].

OBJECTIVE: To study the application of Doppler tissue imaging (TDI) in the assessment of right ventricular function of patients with intraoperative device closure of atrial septal defect (ASD). METHODS: A total of 48 ASD patients, 18 males and 30 females, were selected for intraoperative device closure. The mean age was 31 +/- 16 years old. Color Doppler echocardiographic instrument (Sonos 4500) was employed to perform the Doppler tissue imaging before and at 3-5 days after operation. The parameters included: (1) Time and peak speed of systolic motion of anterior tricuspid valve annulus (TDI-TS, TDI-PVS), early diastole motion time (TDI-TE) and late diastolic motion time (TDI-TA) and peak speed of early and late diastolic motion (TDI-PVE, TDI-PVA), interval between the early diastolic motion and late diastolic motion (TDI-TE-A); (2) Peak speed of systolic, early diastolic and late diastolic motions of the middle lateral and basic lateral walls of right ventricle. RESULTS: The TDI-PVS (0.16 +/- 0.05) m/s in post-operation was decreased than TDI-PVS (0.20 +/- 0.04) m/s in pre-operation and TDI-PVA (0.12 +/- 0.03) m/s in post-operation was decreased than TDI-PVA (0.16 +/- 0.02) m/s in pre-operation apparently (P < 0.01). The TDI-TS (231 +/- 36) msec in post-operation were shorter than TDI-TS (265 +/- 24) msec in pre-operation (P < 0.01). Peak spead of Systolic, early diastolic and late diastolic motions of middle lateral and basic lateral walls of right ventricle declined post-operatively (P < 0.01). CONCLUSION: TDI is an effective method to evaluate the function of right ventricle quantitatively in patients with intraoperative device closure of ASD.

Soil aluminium uptake and accumulation by Paspalum notatum.

Paspalum notatum Flugge has been widely utilized for the purpose of ecological restoration of degraded land in the tropics and subtropics, where soil active aluminium (Al) is usually high as a result of acidification. Pot experiments were conducted to determine Al toxicity on P. notatum and to compare its potential to remove Al with another three plant species, Vetiveria zizanioides, Tristania conferta and Schima wallichii. In the Al addition experiment, the biomass of P. notatum and Al accumulation significantly decreased as the added Al concentration increased, but Al concentration in the plant markedly increased. A parallel experiment was conducted with the above four species, grown in lateritic soil and in oil shale waste containing high concentration of active Al. The biomasses of all four species were reduced obviously in the waste compared to in the soil. The effects of substrate on Al concentration, accumulation and translocation efficiency differed among species, and plants had significantly higher Al accumulation factors when grown in the soil than in the waste. Most of the Al taken up by P. notatum was transferred to above-ground parts; as a result, Al concentration in stems and leaves became quite high, over 1000 or even 3000 mg kg(-1); whereas for the other three species, Al concentration in shoots was much lower than in roots. Paspalum notatum was therefore much higher than the other three species with regard to Al translocation efficiency and therefore P. notatum may be regarded as both an effective Al hyper-accumulator and a potential Al hyper-remover.

Changes in seasonal precipitation distribution but not annual amount affect litter decomposition in a secondary tropical forest.

In the tropics of South China, climate change induced more rainfall events in the wet season in the last decades. Moreover, there will be more frequently spring drought in the future. However, knowledge on how litter decomposition rate would respond to these seasonal precipitation changes is still limited. In the present study, we conducted a precipitation manipulation experiment in a tropical forest. First, we applied a 60% rainfall exclusion in April and May to defer the onset of wet season and added the same amount of water in October and November to mimic a deferred wet season (DW); second, we increased as much as 25% mean annual precipitation into plots in July and August to simulate a wetter wet season (WW). Five single-species litters, with their carbon to nitrogen ratio ranged from 27 to 49, and a mixed litter were used to explore how the precipitation change treatments would affect litter decomposition rate. The interaction between precipitation changes and litter species was not significant. The DW treatment marginally accelerated litter decomposition across six litter types. Detailed analysis showed that DW increased litter decomposition rate in the periods of January to March and October to December, when soil moisture was increased by the water addition in the dry season. In contrast, WW did not significantly affect litter decomposition rate, which was consistent with the unchanged soil moisture pattern. In conclusion, the study indicated that regardless of litter types or litter quality, the projected deferred wet season would increase litter decomposition rate, whereas the wetter wet season would not affect litter decomposition rate in the tropical forests. This study improves our knowledge of how tropical forest carbon cycling in response to precipitation change.

Comparison of contrast enhanced 64-slice computed tomography and transesophageal echocardiography in detection of left atrial thrombus in patients with atrial fibrillation.

BACKGROUND AND OBJECTIVE: Recent advances in multi-slice computed tomography (MSCT) have allowed an improved analysis of left atrial (LA) and left atrial appendage (LAA) anatomy prior to catheter ablation of atrial fibrillation (AF). However, data regarding the ability of MSCT to identify LA/LAA thrombus are limited. This prospective study compared the efficacy of 64-slice contrast-enhanced computed tomography (64CCT) with transesophageal echocardiography (TEE) of the heart in the identification of LA/LAA thrombus. MATERIALS AND METHODS: One-hundred and seventy consecutive patients scheduled for first-time catheter ablation of paroxysmal (n = 120) or persistent (n = 50) AF were enrolled for study. Each patient underwent non-gated 64CCT and TEE of the heart for exclusion of LA/LAA thrombus prior to ablation procedure. RESULTS: Fourteen cases (8.2%) of LA/LAA thrombi were interpreted by 64CCT (ten false-positive, four true positive), whereas 11 actual thrombi (6.5%) were detected by TEE (seven false-negative by 64CCT) in the same population. Maximal dimension of TEE identified thrombi did not differ between the false-negative by 64CCT group and the true-positive group (17 +/- 6 vs. 18 +/- 5 mm P = 0.677). Results indicated 64CCT sensitivity = 36.4%, specificity = 93.7%, positive predictive value = 28.6%, and negative predictive value = 95.5% in the detection of LA/LAA thrombus. The Kappa value in evaluating the agreement between 64CCT and TEE for detection of LA/LAA thrombus was 0.267. CONCLUSION: Compared to gold standard TEE, 64CCT was shown to be less reliable in the detection of LA/LAA thrombus prior to catheter ablation in patients with AF.

Identification of unusual conditions after atrial septal defect repair by systematic transthoracic echocardiographic assessment.

BACKGROUND: There is a lack of echocardiographic studies to address the detection of atrial masses and abnormal venous connections in patients with secundum atrial septal defect (ASD) repair. This study sought to demonstrate that with proper technique, these unusual conditions could be diagnosed confidently by transthoracic echocardiography. METHOD: We performed a retrospective review of all repaired ASD patients of all ages with follow-up echocardiography done at Beijing Anzhen Hospital from year 1999 to 2005. Clinical and echocardiographic features of patients with aforementioned conditions were evaluated. RESULTS: Systematic echocardiographic protocol identified 11 patients with unusual conditions, in whom four patients had atrial masses (three atrial thrombi, one inflammatory pseudotumor) and seven patients had abnormal venous connections (two inadvertent diversion of inferior vena cava to left atrium, five previously unrecognized partial anomalous pulmonary venous connections). CONCLUSION: Atrial masses and abnormal venous connections could be diagnosed through a systematic echocardiographic approach in evaluating patients with ASD repair.